Organ and tissue donor parents’ positive psychological adjustment to grief and bereavement: practical and ethical implications
Keywords:
bereavement adjustment, meaning of life, organ donation, organ transplantation, ethical issues, bereavement measures, complicated griefAbstract
AbstractOrgan transplantation from the deceased typically involves requesting close family members’ consent to procure the deceased’s organs. This raises ethical and clinical concerns whether this difficult decision, taken while they are grieving, might have a long-term impact on their adjustment to bereavement. The study employed five measures of bereavement, adjustment and meaning of life (three developed for this study), administered to 216 bereaved Israeli donor and non-donor parents, mainly of deceased adults. The analysis distinguished between organ/tissue donors and donor/non-donors and determination of death (brain/cardiac). No differences were found according to grief measures or method of diagnosing death but donor parents scored higher on ‘life development’, ‘meaning of life after loss’ and ‘personal growth’. Findings suggest the donation process is not associated with a more negative adjustment to bereavement and might have benefited some donor parents in terms of adjustment to loss or meaning of life and growth, in particular those with higher levels of grief. Methodological and practical implications are discussed.
References
Anker AE, Feeley TH (2011). Asking the difficult questions: message strategies used by organ procurement coordinators in requesting familial consent to organ donation. Journal of Health Communication: International Perspectives 16(6) 643. doi: 10.1080/10810730.2011.551999
Ashkenazi T (2010). The ramifications of child organ and tissue donations for the mourning process and parents’ adjustment to loss. Doctoral Dissertation. Tel Aviv University. (Hebrew).
Ashkenazi T, Lavee J, Mor E (2015). Organ donation in Israel: achievements and challenges. Transplantation 99(2) 265–266. doi: 10.1097/TP.0000000000000591
Bellali T, Papadatou D (2006). Parental grief following the brain death of child: does consent or refusals to organ donation affect their grief? Death Studies 30 883. doi: 10.1080/07481180600923257
Boelen PA et al (2006). Continuing bonds and grief: a prospective analysis. Death Studies 30 767–776. doi: 10.1080/07481180600852936
Bonanno GA (2004). Loss, trauma, and human resilience: have we underestimated the human capacity to thrive after extremely aversive events? American Psychologist 59(1) 20–28. doi: 10.1037/0003-066X.59.1.20
Cleiren M, Van Zoelen AA (2002). Post-mortem organ donation and grief: a study of consent, refusal, and well-being in bereavement. Death Studies 26 837. doi: 10.1080/07481180290106607
Corr CA, Coolican MB (2010). Understanding bereavement, grief, and mourning: implications for donation and transplant professionals. Progress in Transplantation 20: 169. doi: 10.7182/prtr.20.2.w7727276m86241w4
Davis CG, Nolen-Hoeksema S (2001). Loss and meaning: how do people make sense of loss? American Behavioral Scientist 44(5) 726. doi: 10.1177/00027640121956467
Eckenrod EL (2008). Psychological/emotional trauma of donor families. Transplant Proceedings 40(4) 1061. doi: 10.1016/j.transproceed.2008.03.048
Hall C (2014). Bereavement theory: recent developments in our understanding of grief and bereavement. Bereavement Care 33(1) 7–12. doi: 10.1080/02682621.2014.902610
Hogan HS, Coolica M, Schmidt LA (2013). Making meaning in the legacy of tissue donation for donor families. Progress in Transplantation 23(2) 180. doi: 10.7182/pit2013862
Holtkamp S (2002). Wrapped in mourning: the gift of life and organ donor family trauma. Lillington, NC: Edwards Brothers.
Hun S, Greeff AP (2012). Parental bereavement: a panoramic view. Omega 64(1) 41.
Kasher A (2003). Life in the heart. Journal of Loss and Trauma: International Perspectives on Stress & Coping 8(4) 247. doi: 10.1080/15325020305885
Kasher A (2000). Meaning of life. Tel Aviv: Hakibbutz Hameuhad and Yehoraz Association (Hebrew).
Kesselring A, Kainz M, Kiss A (2007). Traumatic memories of relatives regarding brain death, request for organ donation and interactions with professionals in the ICU. American Journal of Transplantation 7 211. doi: 10.1111/j.1600-6143.2006.01594.x
Machin L, Bartlam R, Bartlam B (2015). Identifying levels of vulnerability in grief using the Adult Attitude to Grief scale: from theory to practice. Bereavement Care 34(2) 59–68. doi: 10.1080/02682621.2015.1063859
Manuel A, Solberg S, MacDonald S (2010). Organ donation experiences of family members. Nephrology Nursing Journal 37(3) 229.
Merchant SJ et al (2008). Exploring the psychological effects of deceased organ donation on the families of the organ donors. Clinical Transplantation 22(3) 341. doi: 10.1111/j.1399-0012.2008.00790.x
Neimeyer RA, Holland JM, Currier JM, Mehta T (2008). Meaning reconstruction in later life: toward a cognitive constructivist approach to grief therapy. In: D Gallagher-Thompson, A Steffan, L Thompson (eds). Handbook of behavioral and cognitive therapies with older adults. New York: Springer-Verlag. 264–277.
Neimeyer RA, Sands DC (2011). Meaning reconstruction in bereavement: from principles to practice. In: RA Neimeyer, H Winokuer, D Harris, G Thornton (eds). Grief and bereavement in contemporary society: Bridging research and practice. Routledge; New York. 9–22.
Prigerson HG, Jacobs SC (2001). Traumatic grief as a distinct disorder: a rationale, consensus criteria, and a preliminary empirical test. In: MS Stroebe, RO Hansson, W Stroebe, H Schut (eds). Handbook of bereavement research: consequences, coping, and care. Washington, DC: American Psychological Association 613–645.
Rithalia A, McDaid C, Suekarran S et al (2009). Impact of presumed consent for organ donation on donation rates: a systematic review. BMJ 338: a3162. 237. doi: 10.1136/bmj.a3162
Schaefer JA, Moos RH (2001). Bereavement experiences and personal growth. In: MS Stroebe, RO Hansson, W Stroebe, H Schut (eds). Handbook of bereavement research: consequences, coping, and care. Washington, DC: American Psychological Association 145–167.
Shaw R (2010). Perceptions of the gift relationship in organ and tissue donation: views of intensivists and donor and recipient coordinators. Social Science & Medicine 70 609. doi: 10.1016/j.socscimed.2009.10.062
Siminoff LA, Burant C, Youngner J (2004). Death and organ procurement: public beliefs and attitudes. Social Science & Medicine 59 2325. doi: 10.1016/j.socscimed.2004.03.029
Siminoff LA, Lawrence RH (2002). Knowing patients’ preferences about organ donation: does it make a difference? Journal of Trauma- Injury & Critical Care 53(4) 754–760. doi: 10.1097/00005373-200210000-00023
Stouder DB, Schmid A, Ros SS et al (2009). Family, friends, and faith: how organ donor families heal. Progress Transplantation 19(4) 358. doi: 10.7182/prtr.19.4.f7pm442j62385176
Sque M, Payne S, McLeod CJ (2006). Gift of life or sacrifice? Key discourses for understanding of organ donors’ decision-making by families. Mortality 11(2) 117–132. doi: 10.1080/13576270600615260
Tedeschi RG, Calhoun LG (1996). The posttraumatic growth inventory: measuring the positive legacy of trauma. Journal of Traumatic Stress 9(3) 455. doi: 10.1002/jts.2490090305
Walker W, Broderick A, Sque M (2013). Factors influencing bereaved families’ decisions about organ donation: an integrative literature review. Western Journal of Nursing Research 35(10) 1339. doi: 10.1177/0193945913484987